LOA Form

Letter of Authorization

All information MUST match the current Invoice or Bill “Exactly”
COMPANY NAME
CUSTOMER NAME - Authorized Person as it appears on the current Invoice or Bill*

First NameLast Name
CUSTOMER ADDRESS - as it appears on the current Invoice or Bill*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
BILLING TELEPHONE NUMBER - Number the current carrier has on account*
Please enter a valid phone number.
FULL ACCOUNT NUMBER - That matches the current carriers Invoice or bill*
ACCOUNT PIN - if applicable
Number(s) porting in. For Toll-Free or Fax Numbers fill out a separate LOA form*
Bill or Invoice Upload - Recent within the last 45 days

Invoice or Bill that matches this LOA forum
Cancelof
Those numbers are?

VoiceToll-FreeFax
Caller ID "Name" when dialing out
Up to 15 characters including spaces
RespOrg ID: WLS27
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Letter of Authorization